Unlike Munchausen syndrome, where the affected person induces or fakes illness in themselves, Munchausen-by-proxy is much more insidious. With Munchausen by proxy, the affected person induces illness in another person, often children that they are responsible for. Because of this, Munchausen-by-proxy is considered a form of child abuse.

Munchausen syndrome is difficult enough to catch, but Munchausen-by-proxy can be harder still. Parents (often mothers, as over 90% of Munchausen-by-proxy patients are female) will often take their children to the hospital, telling doctors that their child is ill or injured. Sometimes the child is ill, but often in such cases, the illness has been caused by the affected parent or caregiver. Often the affected person appears so concered about the wellbeing of the child in their care that it can be very difficult for doctors to spot the signs of the abuse.

People who suffer from Munchausen-by-proxy bask in the attention that they get for being such caring and strong parents or caregivers. "That poor woman's daughter is so sick right now, and there she is, bravely holding her child's hand and being strong for them. Isn't she just a great parent!?" The reality, however, is the very opposite, as the sufferer is causing the illness in the child in order to garner attention for themselves. It's bad enough when a person causes harm to themselves to get attention, but to cause it to another makes the situation that much harder.

For all that it's hard to correctly identify if someone has Munchausen-by-proxy, there are some signs that doctors need to be aware of. Sometimes the Munchausen-by-proxy sufferer will say their child has symptoms which do not actually seem to be present, in an attempt to make the situation seem more urgent. Symptoms that do exist often seem to improve while under medical supervision but will worsen again when in the presence of the affected caretaker. Drugs or strange chemicals may be present in the blood or urine, which can either be a sign of the fact that those chemicals were used to create the symptoms in the first place, or that the blood or urine sample was tampered with to make the condition seem worse or more bizarre to medical professionals. The stranger or more serious the ailment, the more attention the caregiver gets, by way of the child.

As with cases of Munchausen syndrome, the affected person is often very willing, even eager, to give their permission for the ill child to undergo medical testing. As the child is not able to give their own permission, the word of the caregiver is what the doctors will take. This means that a child is being submitted to potentially invasive or dangerous tests, with permission given by the adult who made them ill in the first place.

One rather scary thing that should not be overlooked in cases of Munchausen-by-proxy is that sometimes the affected person is a nurse or someone who holds a position within the medical community. This gives them not only the knowledge of symptoms and how to effectively fake them, but also provides them easy access to victims who are not their own children. Once more, they get to be the rock in a stormy sea, and get the praise for how strong they're being and the sympathy if and when the child dies, because they were so close and caring.

In extreme cases, doctors may be alerted to the possibility of Munchausen-by-proxy due to the ill child having siblings who died under mysterious circumstances. The truly sad fact of this condition is that yes, it can kill. It doesn't kill the affected person, but it can kill those for whom the affected person is responsible. Statistics state that approximately 10% of the victims of those affected by Munchausen-by-proxy die. In the case of Munchausen-by-proxy patient Beverly Allitt (see link below), 4 children died and at least 5 others were injured under her 'care'.

The media has used Munchausen-by-proxy a time or two for dramatic purposes. One scene in the famous movie, "The Sixth Sense" features a mother deliberately poisoning her child, which eventually led to the child's death. This scene was probably responsible for opening a lot of eyes to the condition, and created subsequent interest in concerned parents.